Vol 20, No 2 (2018)

Articles
Optimal duration of adjuvant trastuzumab therapy in patients with HER2-possitive early breast cancer: whether the problem is resolved?
Zhukova L.G., Ganshina I.P., Khatkova E.I., Tikhomirova T.E., Kondratyeva O.E.
Abstract
According to the results of the conducted studies in the early 2000’s, adjuvant trastuzumab for 1 year has been admitted the gold standard since 2006. However, the high cost of treatment and the increasing of the risk of cardiotoxicity have led to new clinical trials concerning the short-course trastuzumab regimen. The study deals with the results of the number of the largest randomized trials associated with the comparison of 6 months (the PHARE trial and the HORG study), 9 weeks (the Short-HER study and the SOLD study) and 12 months duration of adjuvant trastuzumab therapy in combination with chemotherapy in patients with HER2-possitive early breast cancer. Today, none of the studies has shown statistically significant evidence of the possibility to reduce the duration of adjuvant trastuzumab therapy.
Journal of Modern Oncology. 2018;20(2):24-28
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Case studies on clinical experience of targeted therapy ribociclib in combination with letrozole in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer
Frolova M.A., Kochetkova Y.I., Chubenko V.A., Volkov N.M., Moiseenko F.V., Garmarnik T.V., Ponomarenko D.M., Orlov A.E., Kostalanova Y.V., Makarycheva Y.Y., Nizegorodzeva A.A.
Abstract
The article represents case studies on clinical experience of targeted therapy ribociclib in combination with letrozole in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer in Russian Federation. Russian oncologists’ experience has demonstrated the high efficacy and manageable safety profile of the ribociclib treatment in patients in clinical practice.
Journal of Modern Oncology. 2018;20(2):29-37
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Ribociclib in 1st line HR+ breast cancer treatment
Zhukova L.G., Ganshina I.P., Gordeeva O.O., Lubennikova E.V.
Abstract
Breast cancer is a leading oncologic disease among women worldwide. Though the achieved results in treating patients with luminal subtypes are high, there is a great demand on new approaches in this field. This article highlights the new CDK4/6 inhibitor ribociclib as well as presents clinical cases from the own clinical practice obtained during phase IIIb COMPLEEMENT trial.
Journal of Modern Oncology. 2018;20(2):38-41
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The first results of the national programme for the diagnosis and treatment of HER2-positive breast cancer in Turkmenistan
Berdimyradova M.B., Khadjiev S.M., Khommadova D.N., Polatova G.O., Kakajanova A.O., Batyrov C.B., Penayev D.N., Agayeva B.G., Annaberdiyeva G.A.
Abstract
Abstract The article deals with the changes in diagnosis and treatment of early and advanced HER2-positive breast cancer (BC) in Turkmenistan during 2010-2018. Early BC detection programme started in Turkmenistan in the year 2010 and the percentage of stage I-II BC detection in the country increased by 8.8% and reached 69.6% in 2017. Automated HER2-testing method in diagnostic breast tumors was carried out in December 2016; the number of immunohistochemical studies was increased in 2 times from December 2016 to December 2017 and the percentage of HER2 status assessment in patients with newly diagnosed disease reached 99%. The central programme of targeted therapy for HER2-positive BC with trastuzumab and pertuzumab, first in patients with advanced-stage cancer, and then in patients with early HER2-positive BC started within the country in 2016. The first results of the application of anti-HER2 therapy in Turkmenistan of advanced-stage cancer showed promising results: the higher clinical efficacy and favourable safety profile in the treatment. The first results of anti-HER2 blockade in the neoadjuvant chemotherapy confirmed the high percentage of the complete morphological regression in HER2-positive BC, and gave us hope for the future associated with higher survival rates.
Journal of Modern Oncology. 2018;20(2):42-44
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The post-mastectomy syndrome: the secondary lympedema after the combined treatment of breast cancer (the literature review and own results)
Stepanova A.M., Merzlyakova A.M., Khulamhanova M.M., Trofimova O.P.
Abstract
The post-mastectomy syndrome and lymphedema after the combined treatment of breast cancer, significantly worsen the quality of life of patients, their psycho - emotional state. The treatment of this disease is always combined in nature, and involves elements of the Complex Decongestive Therapy, pneumatic compression, mild electrical stimulation and low-frequency magnetic therapy. The best results of therapy are achieved with early detection and treatment. Complex treatment of lymphedema does not affect the course of cancer.
Journal of Modern Oncology. 2018;20(2):45-49
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New possibilities in the treatment of EGFR mutation-positive non-small-cell lung cancer patients after the progression on a 1st and 2nd generation EGFR tyrosine kinase inhibitors
Laktionov K.K., Reutova E.V., Nelyubina L.A., Pitkevich M.Y., Okruzhnova M.A., Ardzinba M.S., Yudin D.I., Demidova I.A., Zaretsky A.R.
Abstract
Targeted therapy has opened a new era in treatment of patients with non-small-cell lung cancer associated with mutations of the epidermal growth factor receptor (EGFR) gene. However, most patients after starting targeted therapy develop progression within 10-12 months. The basic mechanisms of acquired resistance are known, the secondary mutation in exon 20 of EGFR gene is the leading cause in more than a half of the cases. To detect this mutation is important to repeat molecular testing, that, consequently, requiring re-biopsy. Liquid biopsy is considered as an alternative to re-biopsy. Osimertinib is a third generation EGFR-tyrosine kinase inhibitor, possessing antitumor activity, both, in respect of T790M-positive tumors and of tumors with mutations in exons 18, 19 and 21. In the randomized AURA3 trial, the use of osimertinib was effective in 71% of patients, the median progression free survival was 11 months after the progression on1st-line targeted therapy and was statistically significant than in case of chemotherapy application. Patients with brain metastases also show response to osimertinib treatment. In our study, 29 patients received osimertinib after the progression on targeted therapy of the 1st and 2nd generation tyrosine kinase inhibitors. Objective response was reported in 44.8% (complete response - 3.4%), stabilization - 51.7% and progression - 3.5%. We will show the results concerning the time without progression in the near future. The tolerance of treatment is good. Osimertinib has been approved for 1st-line targeted therapy treatment of patients with the T790M mutation upon progression in Russian Federation, thus we have new opportunities to improve the results of the treatment in this group of patients.
Journal of Modern Oncology. 2018;20(2):50-54
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Perioperative chemotherapy for gastric cancer: the current state
Lyadov V.K., Pardabekova O.A., Lyadova M.A.
Abstract
Gastric cancer has one of the leading positions in the world in the prevalence and mortality among malignant tumors. The results of surgical treatment of locally advanced gastric cancer remain generally poor due to the high rate of relapse after surgery. Currently, perioperative (pre- and postoperative) chemotherapy in combination with surgery is recommended for patients with stage ≥IB resectable gastric cancer. We analyzed the studies devoted to the problem of choosing the optimal regimen of perioperative chemotherapy in locally advanced and oligometastatic gastric cancer. The highest efficacy was observed in the taxan-containing regimen FLOT which allowed to increase the median overall survival up to 50 months in a randomized controlled phase III trial. The use of perioperative chemotherapy with anti-Her2 therapy, immunotherapy or any other biologic drug remains investigational.
Journal of Modern Oncology. 2018;20(2):56-60
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Surgery for early-stage ovarian cancer
Nechushkina V.M., Morkhov K.Y., Abduragimova Z.T., Kuznetsov V.V., Selchuk V.Y., Dmitriev V.N.
Abstract
Purpose of the literature review: to analyze recent studies of surgical treatment of stage I-II ovarian cancer. Key issues. Individual steps of surgery and their significance, impact of the extent of surgery on the survival and adjuvant treatment, fertility-sparing surgery in young patients and safety of laparoscopic surgery are discussed. Conclusion. Optimal staging of early ovarian cancer was found to be significantly associated with overall and recurrence-free survival.
Journal of Modern Oncology. 2018;20(2):61-65
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